摘要Objective:To explore the effects of Tai Chi on body mass index(BMI),exercise capacity,and mental health of overweight/obese adults,and investigate factors influencing adherence to enhance adherence of Tai Chi as a sustainable exercise method.Methods:A randomized,controlled,exploratory clinical trial was conducted paired with a qualitative study of adherence management.A total of 20 overweight/obese participants were randomly assigned to a standard Tai Chi group(experimental)and a simplified Tai Chi group(control)for an 8-week intervention,10 patients in each group,with a 12-month follow-up.BMI was calculated and exercise capacity including an isokinetic muscle strength and balance ability test were evaluated.Mental health was assessed using the General Well-Being Schedule(GWB),Pittsburgh Sleep Quality Index(PSQI),and Coping Self Efficacy Scale(CSES)at baseline,4th week,and 8th week,respectively.The qualitative research included open-interviews with Tai Chi practitioners and semi-structured interviews with subjects.Results:The intervention was conducted in Haidian Park,Beijing,China from October 6,2022,to January 1,2023,without dropouts.After an 8-week intervention,the participants in the experimental group exhibited a significant decrease in BMI(P＜0.05).Both groups demonstrated significant improvements in exercise capacity(P＜0.05).The experimental group exhibited a significant enhancement in the GWB,PSQI and CSES(P＜0.05).Only GWB had significant difference in the control group(P＜0.05).The experimental group surpassed the control group in GWB and CSES(P＜0.05).The adherence rate was 87.5％in the experimental group and 57.9％in the control group after 8 weeks intervention.Analysis on adherence identified 15 themes,the top 3 themes mentioned were as follows:mind-body effects,online and on-site guidance,training schedule(for subjects);mind-body effects,difficulties in practicing,and understanding of Tai Chi(for practitioners).Conclusions:Both interventions were effective in improving exercise capacity.Standard Tai Chi,integrating both physical and mental conditioning,reduced weight,improved exercise capacity and mental happiness,and increased adherence,providing a sustainable exercise program(ChiCTR2200063599).